Abstract

Introduction : Different biomaterials have been used as a replacement for soft tissue augmentation, such as Mucograft®. For this reason, we consider the use of Mucograft® to thicken the gingiva concomitant with accelerated orthodontic treatment and, hypostatized that it could play a protective role for the periodontium during tooth movement. Objective : The aim of this study was to compare the magnitude of buccal bone dehiscences and fenestrations, before treatment, at completion of treatment, and two years after retention, on mandibular incisors of patients who underwent conventional and accelerated orthodontic treatment with piezocision and/or Mucograft. Materials and Methods: The study sample consisted of cone-beam computed tomography scans, taken before treatment (T0), at completion of treatment (T1) and two years after retention (T2) of 29 patients. The control group (G1) consisted of 9 patients who received conventional orthodontic treatment; the piezocision group (G2) consisted of 6 patients who received accelerated orthodontic treatment with piezocision; the piezocision and Mucograft® group (G3) consisted of 7 patients who underwent accelerated orthodontic treatment with piezocision and anteroinferior soft tissue graft (Geistlich Mucograft®); and the Mucograft® group (G4) consisted of 7 patients who underwent accelerated orthodontic treatment with anteroinferior soft tissue graft only (Geistlich Mucograft®). Buccal dehiscences and fenestrations were measured at baseline, at completion of treatment, and two years after retention. Also, absolute frequency, percentage, and transition degree of dehiscences and fenestrations in each time was evaluated for each incisor. Results: Mandibular buccal Dh showed a statistically significant increase from T0 to T1, and a non-statistically significant decrease from T1 to T2 for all groups. In general, Fn showed non-statistically significant changes at all timepoints. The percentage of Dehiscences increased from T0-T1 especially for G1 and G2 and decrease from T1 to T2 in G2 and G4, in G1 it maintained, and in G3 it increased. The percentage of Fenestrations decreased from T0-T1 especially for G1 and G2, and decrease from T1 to T2 in G3, in G2 it maintained, and in G1 and G4 it increased. Transition degree analysis showed that for teeth that had no dehiscences at T0, G3 and G4 has a better transition than did G1 and G2 at T1. For the incisors having dehiscences at T0, G3 and G4 had a worse transition degree at T1. For incisors without dehiscences at T1, most of it maintain without dehiscence at T2. G2 had a better transition degree than did G1, G3 and G4. For incisors with dehiscences at T1, most of it improved with a decrease of the dehiscences at T2, G1 followed by G4 had a better transition degree than did G2 and G3. For incisors without fenestrations at T0, most of it maintain without fenestration at T1. Incisors with fenestrations at T0, got cured at T1. G1 had a better transition degree than did G2, G3 and G4. Conclusion: Dehiscences significantly increase at completion of orthodontic treatment; and decrease two years after retention for all groups. Mucograft may play a protective role in incisors that does not have dehiscence before treatment, while does not play this protective role when there is already a bone defect at baseline.